title: A systematic review of the effectiveness of contrast baths.
abstract: METHODS
  Systematic review.
  
  
  BACKGROUND
  Contrast baths are used as an intervention in hand therapy, yet it is unclear which patients, if any, benefit from this intervention.
  
  
  OBJECTIVE
  To examine the nature and quality of the evidence regarding the use of contrast baths using a systematic review process.
  
  
  METHODS
  Of a total of 28 clinical research articles on contrast baths, from 1938 forward, ten met the inclusion criteria set by the authors.
  
  
  RESULTS
  These studies addressed the physiological changes of hot and cold on blood flow, intramuscular temperature, subcutaneous temperature, and the influence of room temperature and age. The subjects included normal/healthy volunteers and patients with a diagnosis of rheumatoid arthritis, diabetes, or foot/ankle injuries. The diversity of conditions, protocols, and outcomes limited the ability to make definitive conclusions on efficacy.
  
  
  CONCLUSIONS
  The contrast bath procedure may increase superficial blood flow and skin temperature, though the evidence on the impact on edema is conflicting. No relationship between physiologic effects and functional outcomes has been established.
  
  
  METHODS
  2A.
authors.affiliation: Department of Occupational Therapy, Samuel Merritt College, Oakland, California 94609, USA. dbreger@samuelmerritt.edu
authors.forename: Donna E
authors.initials: DE
authors.lastname: Breger Stanton
authors.forename: Rolando
authors.initials: R
authors.lastname: Lazaro
authors.forename: Joy C
authors.initials: JC
authors.lastname: Macdermid
mesh_terms: D000843:Ankle Joint / Q000503:physiopathology; D001172:Arthritis, Rheumatoid / Q000503:physiopathology / Q000628:therapy; D001494:Baths; D003080:Cold Temperature; D003920:Diabetes Mellitus / Q000503:physiopathology; D004487:Edema / Q000503:physiopathology / Q000628:therapy; D005528:Foot / Q000098:blood supply / Q000503:physiopathology*; D006225:Hand / Q000098:blood supply / Q000503:physiopathology*; D006358:Hot Temperature; D006801:Humans; D018482:Muscle, Skeletal / Q000502:physiology; D009788:Occupational Therapy; D026741:Physical Therapy Modalities; D012039:Regional Blood Flow / Q000502:physiology; D012881:Skin Temperature; D013180:Sprains and Strains / Q000503:physiopathology / Q000628:therapy